110 articles - From Friday Mar 22 2024 to Friday Mar 29 2024
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| J Hepatol |
|---|
Acute kidney injury in patients with Cirrhosis: Acute disease quality Initiative (ADQI) and international Club of ascites (ICA) joint multidisciplinary consensus meeting. Early recognition of HRS-AKI is crucial since administration of splanchnic vasoconstrictors may reverse the AKI and serve as a bridge to liver transplantation, the only curative option. In 2023, a joint meeting of the International Club of Ascites (ICA) and the Acute Disease Quality Initiative (ADQI) was convened to develop new diagnostic criteria for HRS-AKI, to provide graded recommendations for the work-up, management and post-discharge follow-up of patients with cirrhosis and AKI, and to highlight priorities for further research. |
meta-analyses and systematic reviews
| Endosc Int Open |
|---|
Outcomes predictors in endoscopic ultrasound-guided choledochoduodenostomy with lumen-apposing metal stent: Systematic review and meta-analysis. EUS-CDS with LAMS is a safe and effective option for relief of MBO. Selecting an appropriate stent size is crucial for achieving optimal safety outcomes. |
Radiofrequency ablation for ampullary neoplasia with intraductal extension after endoscopic papillectomy: Systematic review and meta-analysis. RFA is feasible and appears to be effective for managing residual or recurrent lesions with intraductal extension after EP. However, long-term follow-up and high-quality studies are required to confirm our findings. |
| Endoscopy |
Endoscopic outcomes using a novel through-the-scope tack and suture system for gastrointestinal defect closure: a systematic review and meta-analysis. TTSS is a novel device for closure of postprocedural defects, with relatively high technical and clinical success rates. Comparative studies of closure devices are needed. |
| Gastroenterology |
Relative Efficacies of Interventions to Improve the Quality of Screening-related Colonoscopy: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials. Several interventions are effective in improving adenoma detection and overall colonoscopy quality, many of which are cost-free. These results can inform endoscopists, unit managers, and endoscopy societies on relative efficacies. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
|---|
Impacts of glucagon-like peptide-1 receptor agonists on the risk of adverse liver outcomes in patients with metabolic dysfunction-associated steatotic liver disease cirrhosis and type 2 diabetes. The use of GLP-1RAs was associated with significant risk reductions in long-term adverse liver outcomes, including hepatic decompensation, portal hypertension, HCC and LT, in MASLD cirrhosis patients with type 2 diabetes. |
| Am J Gastroenterol |
A non-inferiority trial comparing 2 days vs. 5 days of terlipressin and ceftriaxone in terms of 5-day rebleeding for patients with acute gastro-esophageal variceal hemorrhage. After successful endoscopic hemostasis of acute variceal bleeding, combination of 2-day terlipressin infusion and ceftriaxone therapy was not inferior to 5-day regimen in terms of very early rebleeding, with the advantage of shortening hospitalization stay. |
Colorectal Cancer Screening Rates at Federally Qualified Health Centers From 2014 to 2022: Incomplete Recovery From COVID-19 and Worsening Disparities. CRC screening rates at FQHC did not return to prepandemic levels by 2022, and recovery varied by FQHC patient characteristics. Tailored interventions addressing low and decreasing CRC screening rates in FQHC are urgently needed to mitigate worsening CRC disparities. |
GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS INCREASE SOLID GASTRIC RESIDUE RATES ON UPPER ENDOSCOPY ESPECIALLY IN COMPLICATED DIABETIC PATIENTS: A CASE CONTROL STUDY. GLP-1RA use is associated with increased gastric residue on upper endoscopy, particularly in T2DM patients, surpassing the impact of opiates alone. Risk is highest in the presence of T2DM complications, while prolonged fasting and a clear-liquid diet are protective. This increased risk of gastric residue does not appear to translate to an increased risk of procedural complications. |
Long-term Risks for Cirrhosis and Hepatocellular Carcinoma Across Steatotic Liver Disease Subtypes. This study highlights elevated risks of cirrhosis and HCC across various subtypes of SLD compared to non-SLD, emphasizing the importance of behavioral modifications for early prevention. |
Pancreatic Enzyme Use Reduces Pancreatitis Frequency in Children with Acute Recurrent or Chronic Pancreatitis: A report from INSPPIRE. In a retrospective analysis, use of PERT was associated with a reduction in the incidence rate of AP among children with pancreatic sufficient ARP or CP. These results support the need for a clinical trial to evaluate the efficacy of PERT to improve clinical outcomes among children with ARP or CP. |
Recommended Ten Years' Follow-Up Strategy for Small Hepatocellular Carcinoma after Radiofrequency Ablation: A Cost-Effectiveness Evaluation. For small HCC after RFA, the recommended follow-up strategy is CT, with scans scheduled every three months for the first two years, every six months thereafter, and transition to biannual the combination of US screening and AFP testing after five years. |
The Impact of Weight Loss Programs on BMI Trajectory in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease: A Veterans Health Administration Study. A minority of patients experienced significant weight loss through 5 years using lifestyle interventions alone. |
| Clin Gastroenterol Hepatol |
Algorithm Training and Testing for a Non-Endoscopic Barrett's Esophagus Detection Test in Prospective Multicenter Cohorts. A locked 3-MDM panel algorithm for BE/EAC detection using a non-endoscopic CCD demonstrated excellent sensitivity for high risk BE cases in independent validation samples. (Clinical trials.gov NCT02560623, NCT03060642). |
BEHAVIORAL THERAPY FOR FUNCTIONAL HEARTBURN: Recommendation Statements. Gut-directed hypnotherapy and/or cognitive-behavioral therapy are recommended as appropriate behavioral interventions for heartburn symptoms, depending on clinical indication, specific gut-brain targets, and preferred treatment modality (pharmacological vs non-pharmacological). Pre-therapy evaluation of psychosocial processes and candidacy for BGBT are important to determine eligibility for referral to psychogastroenterology services. |
Ultra-Processed Food Consumption and Long-Term Risk of Irritable Bowel Syndrome: A Large-Scale Prospective Cohort Study. Our findings provide evidence that a higher UPF consumption is associated with an increased risk of incident IBS, with a significant dose-response relationship. |
| Endosc Int Open |
Verification of the increase in concomitant dysplasia and cancer with the size of sessile serrated lesions. In cases of SSL, the rate of SSLD and SSL-cancer increased as the lesion diameter increased. A certain rate of SSLD and SSL-cancer was observed even in small SSLs less than 5mm. |
| Endoscopy |
Effect of AI on performance of endoscopists to detect Barrett neoplasia: A Randomized Tandem Trial. BE nonexperts benefitted significantly from the additional AI. BE experts and nonexperts remained below the standalone performance of AI, suggesting that there may be other factors influencing endoscopists to follow or discard AI advice. |
| Gastroenterology |
MAF-5 PREDICTS LIVER FIBROSIS RISK AND OUTCOME IN THE GENERAL POPULATION WITH METABOLIC DYSFUNCTION. The MAF-5 score is a validated, age-independent, inexpensive referral tool to identify individuals at high risk of liver fibrosis and all-cause mortality in primary care populations, using simple variables. |
Risk of esophageal adenocarcinoma after Helicobacter pylori eradication treatment in a population-based multinational cohort study. This absence on an increased risk of esophageal adenocarcinoma after eradication treatment of Helicobacter pylori suggests eradication is safe from a cancer perspective. |
| Gastrointest Endosc |
Assessing Endoscopic Ultrasound-Guided Radiofrequency Ablation in Unresectable Pancreatic Ductal Adenocarcinoma: A Single-Center Historic Cohort Study. Also, RFA may play a role in downstaging cancer with potential OS increase in non-metastatic cases. Large prospective cohorts are required to evaluate this technique in clinical practice. |
Characteristics of factors contributing to follow-up for suspect delayed bleeding after colorectal endoscopic submucosal dissection. In cases of DB after colorectal ESD, a bleeding duration ≤1 day or date from ESD to first hematochezia ≤Day 3 may contribute to follow-up observation without endoscopic hemostasis. |
Endoscopic Ultrasound-guided Fine Needle Aspiration and Biopsy for Cytohistological Diagnosis of Gallbladder Cancer: a multicenter retrospective study. EUS-FNAB was safe and showed high diagnostic performance for patients with suspected GBC, regardless of the target site. When appropriate GB targeting is difficult, targeting the LNs would be a good strategy with comparable outcomes. |
Impact of the Supra-papilla Method on Patency in Distal Malignant Biliary Obstruction: A Multicenter Randomized Controlled Trial. The placement of SEMS using the supra-papilla method resulted in a significantly longer duration of stent patency. It is advisable to place the SEMS using the supra-papilla method in DMBO. Further studies with a larger number of patients are required to validate the benefits of the supra-papilla method. |
Mobile Health technology in pediatric esophagogastroduodenoscopy quality indicators assessment: results from a national program of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition. Pediatric UEP practices in Italy adhere well to established quality standards. Emphasizing the adoption of disease-specific guidelines is crucial for optimizing resources, enhancing diagnostic accuracy, and minimizing unnecessary procedures. Prioritizing patient satisfaction is important for immediate enhancements in practice as well as for future research endeavors. |
| Hepatology |
Digital pathology and spatial omics in steatohepatitis: Clinical applications and discovery potentials. We then highlight the power of multimodal integration of DP augmented by machine learning algorithms with spatial biology. The review concludes with a discussion of the current gaps in knowledge, the limitations and premises of these tools and technologies, and the areas of future research. |
Effects of empagliflozin on liver fat in metabolic-dysfunction associated steatotic liver disease patients without diabetes mellitus: A randomized, double-blind, placebo-controlled trial. Empagliflozin for 52 weeks reduces hepatic fat content in non-diabetic MASLD subjects. (ClinicalTrials.gov Identifier NCT04642261). |
Genetic variation in severe cystic fibrosis liver disease is associated with novel mechanisms for disease pathogenesis. These results identify loci/genes associated with severe CFLD that point to disease mechanisms involving hepatic fibrosis, inflammation and innate immune function, vascular pathology, intracellular signaling, actin cytoskeleton and tight junction integrity, and mechanisms of hepatic steatosis and insulin resistance. These discoveries will facilitate mechanistic studies and the development of therapeutics for severe CFLD. |
Mesenchymal stem cells alleviate mouse liver fibrosis by inhibiting pathogenic function of intrahepatic B cells. Intrahepatic B-cell serve as a target of MSCs, play an important role in the process of MSC-induced amelioration of LF, and may provide new clues for revealing the novel mechanisms of MSC action. |
NK-cell-elicited gasdermin-D-dependent hepatocyte pyroptosis induces neutrophil extracellular traps that facilitates HBV-related acute-on-chronic liver failure. Studying the mechanisms that selectively modulate GSDMD-dependent pyroptosis, as well as its immune landscapes, will provide a novel strategy for restoring liver function of HBV-related ACLF patients. |
Novel proteomic signatures may indicate MRI-assessed intrahepatic fat state and changes; the DIRECT PLUS clinical trial. Our findings suggest novel proteomic signatures that may indicate MRI-assessed intrahepatic fat state and changes during lifestyle intervention. Specifically, CA5A, HAOX1, and THBS2 protein changes are independently associated with IHF% change, and THBS2 protein change is greater in the green-MED/high-polyphenols diet. |
Nutritional aspects of prehabilitation in adults with cirrhosis awaiting liver transplant. Future research is warranted to more accurately evaluate energy needs, evaluate emerging dietary supplementation strategies, and establish the role of nutraceuticals alongside food-based interventions. While the general principles of nutritional prehabilitation are ready for immediate application, future large-scale randomized controlled trials in this space will help to quantify the benefit that can be gained by transitioning the LT approach from passive "transplant waitlist time" to active "transplant preparation time." |
Quality measures in pre-liver transplant care by the Practice Metrics Committee of the American Association for the Study of Liver Diseases. The proposed pre-LT measures provide a framework for quality improvement and care standardization among LT candidates. Select measures apply to various stakeholders such as referring practitioners in the community and LT centers. Clinically meaningful measures that are distinct from those used for regulatory transplant reporting may facilitate local QI initiatives to improve access and quality of care. |
The association between mean arterial pressure and acute kidney injury reversal among decompensated cirrhosis patients. Our data demonstrate that MAP significantly increases the likelihood of AKI recovery regardless of severity or injury or AKI phenotype. We believe these data highlight the importance of MAP as a clinical tool to promote kidney function recovery among cirrhosis patients hospitalized with AKI. |
The future of Liver Transplantation. Research efforts in liver preservation will undoubtedly blossom with the aim of optimizing both the timing and conditions of transplantation. Coupled with advances in genetic engineering, regenerative biology, and cellular therapies, the portfolio of innovation, both broad and deep, offers promise that, in the future, liver transplantation will not only be broadly available to those in need but also represent a highly durable life-saving therapy. |
| J Hepatol |
ALT to qHBsAg ratio predicts long-term HBsAg seroclearance after entecavir cessation in Chinese patients with chronic hepatitis B. The ALT/qHBsAg ratio after entecavir cessation predicts HBsAg seroclearance, even in patients who were resumed on treatment. Its use may mitigate the risk of severe hepatitis flares in patients managed by observation without treatment resumption. |
Evaluation of a delayed liver transplantation strategy for patients with HCC receiving bridging therapy: the DELTA-HCC study. The DELTA HCC study shows that DS does not negatively impact neither pre- nor post-LT patients 'outcomes, and has the potential to redistribute organs to patients in more urgent need of LT. It can reasonably be proposed and pursued. The unexpected high risk of drop out in T1 patients seems related to the MELD-based driving rules underserving this subgroup, calling for revision of allocation rules. Impacts and implications To maximize utility and prevent premature liver transplantation (LT), a delayed LT strategy (DS) was adopted in France in 2015. It consists in postponing LT until recurrence in patients listed for any single HCC curatively treated by surgical resection or thermal ablation. The DELTA HCC study was conducted to evaluate this nationwide strategy. It shows in a non-US, European LT program that DS - does not negatively impact pre- nor post-LT patients 'outcome,- concerns up to 20% of LT candidates-has therefore the potential to redistribute organs to patients in more urgent need of LT. Such a delayed strategy can reasonably be pursued and extended to other LT programs. Of note, an unexpected high risk of drop out in T1 patients, seemingly related to MELD-based offering rules which underserve these patients, calls for further scrutinization and revision of allocation rules in this subgroup. |
Post-treatment LSM rather than change during treatment predicts decompensation in patients with cACLD after HCV cure. FU-LSM is key for risk stratification after HCV-cure and should guide clinical decision-making. LSM dynamics do not hold significant prognostic information in patients with FU-LSM 10-19.9 kPa, and thus, their consideration is not of sufficient incremental value in the specific context of HCV-cure. |
Transplant benefit-based offering of deceased donor livers in the United Kingdom. In the first two years of NLOS offering, waiting list mortality fell while post-transplant survival was not negatively impacted, delivering on the scheme's objectives. Impact and implications The National Liver Offering Scheme (NLOS) was introduced in the UK in 2018 to increase transparency of the deceased donor liver offering process, maximise the overall survival of the waiting list population, and improve equity of access to liver transplantation. To our knowledge, it is the first scheme that offers organs based on statistical prediction of transplant benefit; the Transplant Benefit Score (TBS). The results are important to the transplant community - from healthcare practitioners to patients - and demonstrate that, in the first two years of NLOS offering, waiting-list mortality fell while post-transplant survival was not negatively impacted, thus delivering on the scheme's objectives. The scheme continues to be monitored to ensure that the TBS remains up-to-date and that signals that suggest the possible disadvantage of some patients are investigated. |
Treatment response and clinical event-free survival in autoimmune hepatitis: a Canadian multicentre cohort study. In people living with AIH, sustained elevated aminotransferase values, but not IgG, are associated with poorer long-term outcomes. Biochemical response and long-term survival are not associated with starting prednisone dose. Impact and implications Using clinical data from multiple Canadian liver clinics treating autoimmune hepatitis (AIH), we evaluate treatment response and clinical outcomes. For the first time, we apply mixed-effect and time-varying survival statistical methods to rigorously examine treatment response and the impact of fluctuating liver biochemistry on clinical event-free survival. Key to the study impact, our data is 'real-world', represents a diverse population across Canada, uses continuous measurements over follow-up, and our findings help inform risk stratification of patients. We provide evidence for treating clinicians, as well as those developing and evaluating new therapies, to seek evidence of good treatment response by keeping aminotransferase activity values within the reference range. Our results challenge the role of IgG as a marker of treatment response and if normalisation of IgG should remain an important part of the definition of biochemical remission. Our analysis further highlights that baseline markers of disease severity may not prognosticate early treatment response. Additionally, the initial prednisone dose may be less relevant for achieving aminotransferase normalisation. This is important for patients and treating clinicians given the relevance and importance of side-effects of treatment for patients. |
| J Neurogastroenterol Motil |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
|---|
Review article: Recent advances in ascites and acute kidney injury management in cirrhosis. New treatment strategies emerged from better understanding of the pathophysiology of ascites and HRS-AKI have shown improved prognosis in these patients. The future will see many of these approaches confirmed in large multi-centre clinical trials with the aim to benefit the patients with ascites and HRS-AKI. |
Review article: Upper gastrointestinal bleeding - review of current evidence and implications for management. Management of acute UGIB should include treatment plans for pre-endoscopic, endoscopic and post-endoscopic phases of care, and customise treatment decisions based on aetiology and severity of bleeding. |
Systematic scoping review: Use of the faecal immunochemical test residual buffer to enhance colorectal cancer screening. This scoping review summarises the framework and progress of research on stability of biomarkers in FIT residual buffer and their associations with colorectal neoplasia to guide opportunities for further confirmatory studies to enhance colorectal cancer screening. |
The epidemiology and management of Clostridioides difficile infection-A clinical update. Although the prevalence of C. difficile infection remains high, there have been significant advances in the development of novel therapeutics and preventative measures following changes in recent practice guidelines, and will continue to evolve in the future. |
| Clin Gastroenterol Hepatol |
THE GLOBAL EPIDEMIOLOGY OF NON-ALCOHOLIC FATTY LIVER DISEASE AND NON-ALCOHOLIC STEATOHEPATITIS AMONG PATIENTS WITH TYPE 2 DIABETES. The prevalence of NAFLD/MASLD among T2D is high and growing. The majority of NAFLD/MASLD patients with T2D have NASH/MASH and a significant proportion have advanced fibrosis. |
| Endosc Int Open |
Standard screening high-definition colonoscopy without any optimization device is no longer relevant: Time to move to optimized screening colonoscopy. However, despite substantial and consistent data, practices remain unchanged, and HD-WLI colonoscopy, considered the "standard," is still routinely performed without any optimization devices. The objective of this viewpoint is to understand the barriers to change and to show why standard screening colonoscopy without the use of any optimization devices should no longer be considered relevant in 2024. |
| Gastroenterology |
| Gut |
Recent advances in the prevention and treatment of decompensated cirrhosis and acute-on-chronic liver failure (ACLF) and the role of biomarkers. Furthermore, classification of disease and biomarker discovery to personalise care have advanced in the field. This review discusses progress in biomarker discovery and personalisation of treatment in decompensated cirrhosis and ACLF. |
| J Hepatol |
Developing and Validating Clinical Prediction Models in Hepatology-an Overview for Clinicians. We use them to assign a diagnosis or a prognosis, and there is a continuous effort to develop better prediction models. It is important to understand the fundamentals of prediction modeling, and here we describe nine steps to develop and validate a clinical prediction model with the intention of implementing it in clinical practice: Determine if there is a need for a new prediction model; define the purpose and intended use for the model; assess the quality and quantity of the data you wish to develop the model on; develop the model using sound statistical methods; generate risk predictions on the probability scale (0-100%); evaluate the performance of the model in terms of discrimination, calibration, and clinical utility; validate the model using bootstrapping to correct for the apparent optimism in performance; validate the model on external datasets to assess the generalizability and transportability of the model; and finally publish the model so that it can be implemented or validated by others. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
|---|
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
|---|
| Clin Gastroenterol Hepatol |
| Gut |
| J Hepatol |